[New surgical technique for the repair of abdominal hernia with mesh]

The use of prostheses is indispensable in major anterior abdominal hernias when it is not possible to close the edges of the hernial opening without strain. The most commonly used prostheses are made from dacron, polypropylene (PPNE) and expanded polytetrafluoroethylene (EPTF) mesh. It is important to point out that, in spite of the excellent characteristics of these materials, there is no ideal prosthesis. There is a well-known increase in the risk of rejection and infection when mesh is placed in contact with the subcutis and the formation of adhesions, with the possibility of occlusions and fistulas, when it is in direct contact with the intestine. Whereas EPTF does not cause problems of adhesion, it has a greater tendency to cause rejection and infection if placed in the subcutaneous area. Moreover, there is a increased risk of displacement and it is also very costly. The opposite is true of dacron and PPNE mesh. When the mesh serves to "replace" a wall defect and it cannot be isolated by the interposition of the peritoneum or muscular fascia, it comes into direct contact with the intestine and subcutaneous tissue. The technique outlined here aims to isolate the prosthesis from the intestinal loops and subcutaneous tissue. The hernial sac itself is used for this purpose and is divided into two flaps by a cut perpendicular to the wall. The free edge of one flap is sutured to the inside of the hernial opening. The mesh is then sutured half inside and half outside the hernial opening.(ABSTRACT TRUNCATED AT 250 WORDS)